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Like healthcare providers, insurance companies face unprecedented challenges to their status quo. Many of these are the result of mandates included in the Patient Protection and Affordable Care Act of 2010.

Among these are:

  • The rising cost of healthcare: Doctors, hospitals, labs, rehabilitation facilities, nursing homes, pharmaceutical companies, manufacturers of medical equipment — every organization contributing to patient care directly or indirectly — are all raising prices at rates far ahead of inflation.
  • The rising cost of manual claims processing: The majority of claims are still processed manually, on paper. This is prodigiously expensive and the cost is still rising. Modern IT platforms can cut the cost of a claim by up to 90%. But many payers don’t have those technologies, and they are expensive to buy.
  • Regulatory pressure on insurance premiums: The new Act mandates MLRs (Medical Loss Ratios) of 80-85% depending on the size of the insured groups.
  • Non-standardized records: Payers must accept patient and claim information from a multitude of providers: individual therapists, group practices, pharmacies, hospitals and more. These providers have their own unique requirements for data exchange, and many are still providing information on paper. These impose large overheads in additional time, effort and money.
  • Paper checks: Many providers are unable to process electronic reimbursements, and require payment via paper checks. This adds to costs and often delays the inflow of cash.
  • Increased life expectancy: Many insurance plans run by employer or business groups based their budgets on older life expectancy data. But more people are now living longer, driving the cost of these plans up to unaffordable levels.
  • Ensuring the right care is delivered: Subscribers often hold insurers responsible if they receive inappropriate care.

How can NDS help payers maintain profitability?

Our services for healthcare claims processing and payment distribution management help to:

  • Minimize the interval between submitting claims and receiving payments by shifting to a digital process
  • Reduce errors in claims and billing
  • Reduce the need for follow-up with payers

Specific Benefits

  • Technology: Many payers don’t have the expensive IT systems required to process claims electronically. NDS does.
  • Accuracy: NDS improves the accuracy of claims data received. This dramatically increases the number of automatically adjudicated claims, lowering the total cost. It also allows greater visibility of the kind of care actually delivered.
  • Standardized processing across providers: We create a uniform workflow for your many providers, relieving you of the costly overheads associated with catering for their individual needs.
  • Payment distribution management: Using advanced payment technology rather than paper checks also ensures timely payments on a lower budget.
Revenue Cycle
NDS is the perfect partner for outsourced management of your Revenue Cycle Management (RCM) processes, including patient registration, eligibility verification, billing, A/R follow-up and more.
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NDS Delivery
To build effective solutions for our customers, we follow a time tested four-step procedure that delivers powerful tools customized to their specific requirements.
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Client Success
NDS has a decade-long record of designing customized solutions to improve business processes, in various industry sectors, using advanced technologies and innovative techniques.
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